Pairing Technology and Teamwork To Tackle High Blood Pressure

In a new JAMA Network Open article, Integrating a High Blood Pressure Advisory Across a Primary Care Network, Stanford Department of Medicine faculty tested an electronic health record- (EHR-) based system designed to improve blood pressure management in primary care offices.

The system alerted medical assistants to recheck high blood pressure readings using the ideal technique. If the patient's blood pressure remained elevated, the EHR triggered a follow-up alert for clinicians with a recommended order panel.

Medical assistants generally reported positive experiences, while clinician feedback was more mixed. Some appreciated the intervention's visibility and EHR integration, while others found the alerts disruptive and described the order panel as too complex.

The research demonstrated that this team-based approach, which combined technology with workflow changes, led to better detection and control of high blood pressure across participating primary care clinics.

Key Takeaways

1) Improved Blood Pressure Control

In 8 clinics, the likelihood of controlling high blood pressure improved by an average of 18% per month with the intervention.

2) More New Diagnoses

Across 28 clinics, new diagnoses of hypertension rose from 12% to 20.6%, indicating better detection through the electronic prompt system.

3) Increased BP Rechecks, But No Medication Change

After the new alert system rolled out, clinics were much more likely to double-check high blood pressure — doing so in 78% of visits (up from 38%). But even with more rechecks, doctors didn’t prescribe more medications.

4) Medical Assistants Played a Key Role

Medical assistants were highly engaged and integral to the intervention’s success, often taking ownership of rechecking blood pressure.

About this research

This research was proudly conducted by faculty in the Division of Primary Care and Population Health at Stanford Medicine.

Authored by Anuradha Phadke, MD; Yingjie Weng, MHS; Cati Brown Johnson, PhD; Marcy Winget, PhD; Megan Mahoney, MD, Christopher Sharp, MD; Amelia Sattler, MD; Shreya Shah, MD; Manisha Desai, PhD; Stanley Ng, MD; and Jonathan G. Shaw, MD, MS.

Read the full study

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